Error message

  • Notice: Trying to access array offset on value of type null in _webform_client_form_rule_check() (line 2079 of /var/www/martel/sites/all/modules/webform/webform.module).
  • Notice: Trying to access array offset on value of type null in _webform_client_form_rule_check() (line 2079 of /var/www/martel/sites/all/modules/webform/webform.module).
  • Notice: Trying to access array offset on value of type null in _webform_client_form_rule_check() (line 2079 of /var/www/martel/sites/all/modules/webform/webform.module).
  • Notice: Trying to access array offset on value of type null in _webform_client_form_rule_check() (line 2079 of /var/www/martel/sites/all/modules/webform/webform.module).
  • Notice: Trying to access array offset on value of type null in _webform_client_form_rule_check() (line 2079 of /var/www/martel/sites/all/modules/webform/webform.module).
  • Notice: Trying to access array offset on value of type null in _webform_client_form_rule_check() (line 2079 of /var/www/martel/sites/all/modules/webform/webform.module).
  • Notice: Trying to access array offset on value of type null in _webform_client_form_rule_check() (line 2079 of /var/www/martel/sites/all/modules/webform/webform.module).
  • Notice: Trying to access array offset on value of type null in _webform_client_form_rule_check() (line 2079 of /var/www/martel/sites/all/modules/webform/webform.module).
  • Notice: Trying to access array offset on value of type null in _webform_client_form_rule_check() (line 2079 of /var/www/martel/sites/all/modules/webform/webform.module).
  • Notice: Trying to access array offset on value of type null in _webform_client_form_rule_check() (line 2079 of /var/www/martel/sites/all/modules/webform/webform.module).
  • Notice: Trying to access array offset on value of type null in _webform_client_form_rule_check() (line 2079 of /var/www/martel/sites/all/modules/webform/webform.module).
  • Notice: Trying to access array offset on value of type null in _webform_client_form_rule_check() (line 2079 of /var/www/martel/sites/all/modules/webform/webform.module).
  • Notice: Trying to access array offset on value of type null in _webform_client_form_rule_check() (line 2079 of /var/www/martel/sites/all/modules/webform/webform.module).
  • Notice: Trying to access array offset on value of type null in _webform_client_form_rule_check() (line 2079 of /var/www/martel/sites/all/modules/webform/webform.module).
  • Notice: Trying to access array offset on value of type null in _webform_client_form_rule_check() (line 2079 of /var/www/martel/sites/all/modules/webform/webform.module).

BFIS-LF: Self-Report

Screening Visit

Submitted by Lab on Sun, 03/10/2013 - 11:27

How much difficulty do you have functioning effectively in each of these major life activities? That is, to what degree do you see yourself as being impaired in each of these life domains? Please indicate the number next to each item that best describes your difficulties in functioning DURING THE PAST 6 MONTHS with 0 meaning "not at all" and 9 meaning "severely impaired". If the situation does not apply to you (for instance, you don't drive a car, don't have children, don't live with anyone, etc.), indicate 888.